The economic benefits of information technology in healthcare
7 November 2006 An EU project has demonstrated that information
technology can provide enormous benefits if the technology is properly
implemented. The eHealth Impact project developed a methodology for
assessing the economic impact of ehealth solutions and then evaluated the
economic benefits of introducing new technology in healthcare in ten
flagship projects. Electronically enhanced healthcare has long been
promoted as reducing costs, improving quality and efficiency and treating
more patients with the same resources. However, no reliable data had been
available to support this claim. Now that data exists.
The eHealth Impact project, which finished in May 2006, conclusively
demonstrated that there is over a 2:1 ratio between economic benefits and
costs. In other words, the benefits gained from implementing eHealth systems
are more than two times greater than the additional cost of implementing
them.
"An eHealth system might cost more, but the benefits far outweigh the
costs," says Alexander Dobrev of the project team. "But that ratio needs to
be treated with caution," he warns. "This is the cumulative average from ten
of the best eHealth implementations we could find in Europe."
Assessing the impact of ehealth eHealth Impact was set up to
discover what, if any, is the impact of ehealth projects on cost efficiency,
quality of care and citizen access to health services. To answer that
question, the project team developed a methodology for assessing the
economic impact of ehealth solutions, identified 100 examples of good
ehealth services, and then applied the method to ten flagship projects.
During the research, the team discovered that ineffective ehealth services
are often caused by poor service implementation. They therefore analysed the
ten evaluated sites to identify lessons to be learned for successful
implementation of effective ehealth solutions. Past assessments of ehealth
technology were often applied on a case-by-case basis. With a standard
methodology, assessment is simpler and it is possible to compare between
differing initiatives. From supply chains to ambulances
Developing a methodology that can be applied to any ehealth service was
difficult. "Any service that uses ICT in a way that impacts health services
is an ehealth solution. That's a very broad definition and applies to a very
wide range of services," says Dobrev. Such services range from ICT in the
healthcare supply chain, through telemedicine and teleradiology, to
electronic health records, vaccination programmes and even tele-triage,
where emergencies are prioritised to deliver a best match between ambulance
team and equipment and the severity and urgency of cases. With such a wide
variety of services, developing a standard assessment methodology for all
was a tough challenge. eHealth Impact focused on the three stages in the
lifecycle of ehealth investments — planning and development, implementation,
and routine operation. The project team developed a set of tools to collect
relevant information on each stage (these tools are hosted as a handbook on
the project website
www.ehealth-impact.org ). This approach meant the project could draw
lessons from a wide variety of European projects to identify universal
success factors. Staff need to be on board "There are some key
elements required to roll-out a successful ehealth project," Dobrev remarks.
All relevant stakeholders — be they patients, doctors, nurses, management,
public authorities or industry — must be represented from the very beginning
of the planning process. "The more stakeholders and the earlier they are
brought in, the greater the chances of success." Successful projects also
require changes in working practices. Technology will make no difference if
hospital management and/or healthcare professionals don't move to take
advantage of it. "There are cases where staff still work with paper even
though an electronic health record system is in place, which just increases
the workload for no benefit," Dobrev emphasises. Successful implementation
therefore means getting the staff on board; a process which should be part
of a long-term vision. "Results don't come in a big bang, on average it
takes five years for the benefits to exceed costs. It might come earlier,
but you can't plan the project on that basis," Dobrev stresses.
Implementation projects therefore require strong organisation, and the
backing from clinical leadership and management to see them through.
Cost not the deciding factor However, Dobrev emphasises, ehealth is
not about costs alone. "We provide an economic analysis, that looks at
social impacts, the quantity and quality of patient care, the efficient use
of resources. Cost alone cannot be the deciding factor," he warns. "People
still question whether there's any real benefit to ehealth. Often there is
not, if projects fail to address the success factors, at least to some
extent. But with the results from our project, policymakers, clinicians, and
hospital managers now have the tools to both assess and implement a
successful ehealth initiative," Dobrev remarks. eHealth Impact ended in
May 2006, and Dobrev says that the partners would be interested in working
with organisations engaging in an ehealth initiatives. The team would
welcome approaches from interested parties such as healthcare providers,
insurers, or health authorities. In the meantime, the work will continue
through a second, follow-on project, called Good eHealth, which will
identify 120 ehealth implementations and provide a synopsis of their
purpose.
Source: Information Society Technologies:
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